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三种评估关节弹响临床技术的比较。

Comparison of three clinical techniques for evaluating joint sounds.

作者信息

Hardison J D, Okeson J P

机构信息

Department of Oral Health Practice, University of Kentucky.

出版信息

Cranio. 1990 Oct;8(4):307-11. doi: 10.1080/08869634.1990.11678329.

Abstract

Two-hundred two consecutive adult patients presenting to the University of Kentucky for general dental care screening were examined for temporomandibular joint sounds by three techniques: (1) lateral pole surface palpation, (2) digital palpation in the external auditory canal, (3) auscultation by a stethoscope. Sixty-nine patients reported joint sounds, but only 32 had sounds diagnosed by auscultation resulting in a 54% false-negative reporting rate. Stethoscopic auscultation was used as the standard to which the other two techniques were compared. The false-negative rate for auditory canal digital palpation was 71% and 77% for lateral pole surface palpation. Surface palpation had only a 2% false-positive incidence while auditory canal digital palpation had a 51% false-positive rate. There was poor agreement between the patients' subjective reporting and clinical exam by any technique. Using stethoscopic auscultation as the standard, both auditory canal and surface palpation had a very high false-negative rate, but only the auditory canal palpation had a poor false-positive incidence. Auditory canal palpation often produces TMJ sounds that are not heard with a stethoscope during normal opening and closure.

摘要

连续202名到肯塔基大学进行普通牙科检查的成年患者,通过三种技术对颞下颌关节声音进行了检查:(1)外侧极表面触诊,(2)外耳道内指诊,(3)听诊器听诊。69名患者报告有关节声音,但只有32名通过听诊确诊有声音,导致假阴性报告率为54%。以听诊作为标准,将其他两种技术与之进行比较。外耳道指诊的假阴性率为71%,外侧极表面触诊的假阴性率为77%。表面触诊的假阳性发生率仅为2%,而外耳道指诊的假阳性率为51%。患者的主观报告与任何技术的临床检查之间的一致性都很差。以听诊作为标准,外耳道触诊和表面触诊的假阴性率都非常高,但只有外耳道触诊的假阳性发生率较差。外耳道触诊经常会产生在正常开闭过程中听诊器听不到的颞下颌关节声音。

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